RESUMO
This review of the literature is devoted to the problem of acute kidney injury (AKI) in patients with acute myocardial infarction (MI). We discuss the occurrence of AKI in patients with MI, mechanisms of its development and modern diagnostic methods. The article examines biomarkers of kidney injury that may be useful for early diagnostics of AKI.
Assuntos
Injúria Renal Aguda , Rim/diagnóstico por imagem , Infarto do Miocárdio , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/fisiopatologia , Biomarcadores/análise , Diagnóstico Precoce , Humanos , Infarto do Miocárdio/complicações , Infarto do Miocárdio/fisiopatologiaRESUMO
24 hr monitoring of arterial pressure (AP) in 46 patients with acromegaly in active phase revealed systolic-diastolic arterial hypertension. Analysis of diurnal profile showed the absence of the normal nocturnal fall in AP (non-dipper profile) and the significant rise in the number of patients with elevated nocturnal AP (night-peakers).
Assuntos
Acromegalia/fisiopatologia , Pressão Arterial/fisiologia , Ritmo Circadiano/fisiologia , Hipertensão , Acromegalia/complicações , Acromegalia/diagnóstico , Adulto , Monitorização Ambulatorial da Pressão Arterial/métodos , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/etiologia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-IdadeRESUMO
AIM: to study effectiveness of a fixed combination of perindopril arginine and amlodipine besylate for the treatment of arterial hypertension with concomitant chronic cardiac insufficiency and signs of chronic kidney disease Materials and methods: 53 (44.9%) patients aged 64.5±8.2 yr with signs of chronic kidney disease (CKD) were selected from 118 subjects with grade II-III essential AH and chronic cardiac insufficiency They had an increased blood cystatin C level (mean 1.4±0.3 mg/l) and/or decreased glomerular filtration rate (GFR) calculated by 3 formulas: 77.6±15.9 (MDRD), 79.3±17.1 (CKD-EPI) and 57.7±15.2 ml/min/1. 73 m3 (from cystatin C level). Fixed combinations of perindopril arginine and amlodipine besylate (5/5, 5/10, 10/10 mg) were used to treat the patients. Their effectiveness was evaluated 2 months after the onset of therapy based on results of AP measurement, 24 hr AP monitoring, assessment of clinical conditions and 6 min walk test. Blood creatinine, urea and cystatin C levels and GFR were measured. RESULTS: Target AP was achieved in 82.6% of the patients. Systolic AP (SAP) decreased significantly from 172±11.2 to 135.7±8.2 mmHg (p<0.01), diastolic AP (DAP)from 110±6.9 to 85.3±7.2 mm Hg (p<0.5). Mean daily SAP and DAP decreased by 14.7 and 14.4% respectively. SAP and DAP load also decreased Clinical conditions estimated in terms of the CCI functional class improved (a decrease from 6.2±1.1 to 4.2±1.3 scores (p<0.01)). Tolerance of physical activity increased from 157.2±12.6 to 320.4±32.2 m (p<0.05). Blood cystatin C level decreased and GFR increased. CONCLUSION: The fixed combination of perindopril arginine and amlodipine besylate ensures high therapeutic effect in patients with arterial hypertension and concomitant chronic cardiac insufficiency having signs of chronic kidney disease.
Assuntos
Anlodipino , Pressão Sanguínea/efeitos dos fármacos , Insuficiência Cardíaca , Hipertensão/tratamento farmacológico , Perindopril , Insuficiência Renal Crônica , Idoso , Anlodipino/administração & dosagem , Anlodipino/efeitos adversos , Anti-Hipertensivos/administração & dosagem , Anti-Hipertensivos/efeitos adversos , Combinação de Medicamentos , Monitoramento de Medicamentos , Feminino , Seguimentos , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/fisiopatologia , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Testes de Função Renal/métodos , Masculino , Pessoa de Meia-Idade , Perindopril/administração & dosagem , Perindopril/efeitos adversos , Estudos Prospectivos , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/fisiopatologia , Federação Russa , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
PURPOSE: to assess efficacy of a fixed combination of perindopril arginine and amlodipine besylate in the treatment of hypertensive patients with chronic heart failure (CHF) and signs of chronic kidney disease (CKD). MATERIAL AND METHODS: Persons with CKD (n=53, age 64.5+/-8.2years) were selected from 118 patients with grade 2-3 essential hypertension with CHF. Presence of CKD was confirmed by elevated blood levels of cystatin C and lowered glomerular filtration rate (GFR). Used doses of fixed perindopril/amlodipine combination were 5/5, 5/10, 10/10mg. Efficacy was assessed after 2 months of therapy on the basis of results of the examination which included clinical blood pressure (BP).